Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 891 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.
Eur Radiol. 2018 Jul;28(7):2890-2902. doi: 10.1007/s00330-018-5330-5. Epub 2018 Feb 15.
To assess the sensitivity and specificity of quantitative assessment of the apparent diffusion coefficient (ADC) for differentiating benign and malignant vertebral bone marrow lesions (BMLs) and compression fractures (CFs) METHODS: An electronic literature search of MEDLINE and EMBASE was conducted. Bivariate modelling and hierarchical summary receiver operating characteristic modelling were performed to evaluate the diagnostic performance of ADC for differentiating vertebral BMLs. Subgroup analysis was performed for differentiating benign and malignant vertebral CFs. Meta-regression analyses according to subject, study and diffusion-weighted imaging (DWI) characteristics were performed.
Twelve eligible studies (748 lesions, 661 patients) were included. The ADC exhibited a pooled sensitivity of 0.89 (95% confidence interval [CI] 0.80-0.94) and a pooled specificity of 0.87 (95% CI 0.78-0.93) for differentiating benign and malignant vertebral BMLs. In addition, the pooled sensitivity and specificity for differentiating benign and malignant CFs were 0.92 (95% CI 0.82-0.97) and 0.91 (95% CI 0.87-0.94), respectively. In the meta-regression analysis, the DWI slice thickness was a significant factor affecting heterogeneity (p < 0.01); thinner slice thickness (< 5 mm) showed higher specificity (95%) than thicker slice thickness (81%).
Quantitative assessment of ADC is a useful diagnostic tool for differentiating benign and malignant vertebral BMLs and CFs.
• Quantitative assessment of ADC is useful in differentiating vertebral BMLs. • Quantitative ADC assessment for BMLs had sensitivity of 89%, specificity of 87%. • Quantitative ADC assessment for CFs had sensitivity of 92%, specificity of 91%. • The specificity is highest (95%) with thinner (< 5 mm) DWI slice thickness.
评估表观扩散系数（ADC）定量评估鉴别良性和恶性椎体骨髓病变（BML）和压缩性骨折（CF）的敏感性和特异性。
对 MEDLINE 和 EMBASE 进行电子文献检索。进行双变量建模和分层汇总受试者工作特征曲线建模，以评估 ADC 鉴别椎体 BML 的诊断性能。进行亚组分析以鉴别良性和恶性椎体 CF。根据研究对象、研究和弥散加权成像（DWI）特征进行荟萃回归分析。
纳入 12 项符合条件的研究（748 个病变，661 例患者）。ADC 鉴别良性和恶性椎体 BML 的汇总敏感性为 0.89（95%置信区间 [CI] 0.80-0.94），特异性为 0.87（95% CI 0.78-0.93）。此外，ADC 鉴别良性和恶性 CF 的汇总敏感性和特异性分别为 0.92（95% CI 0.82-0.97）和 0.91（95% CI 0.87-0.94）。荟萃回归分析中，DWI 层厚是影响异质性的重要因素（p<0.01）；较薄的层厚（<5mm）比较厚的层厚（81%）具有更高的特异性（95%）。
ADC 定量评估是鉴别良性和恶性椎体 BML 和 CF 的有用诊断工具。
